Did you have a gene assay/Oncotype DX ?

jendrey

After about 10 months of only seeing a NP, I finally see the oncologist and one of the things I asked was if there was an Oncotype DX or other gene assay done.

He very arrogantly told me no. When I inquired as to why not he said, and I quote: "Because we already know how to treat cancer."

I think I was more stunned by his condescending demeanor than anything else.

So, I'm wondering is a gene assay/Oncotype DX common or not?

sbmly53

The Onco Dx Test was only offered to me
after I had a little meltdown regarding chemo & port placement. It was then that the Onc mentioned it. Insurance okayed it - and my score was 4. I opted out of chemo and had radiation. My bc was Invasive Ductal. Lumpectomy with clear margins, 1 positive node.

You need to have all options open to you and you need a compassionate oncologist who is open to everything available.

Sue

Rague

Didn't have any done.
My Dr saw no need to do genetic testing - For at least 4 generations there has been no known cancer of any kind on either side of my family, with the women usually living into their nineties and a coupld past 100. Also IBC is not usually genetic - but rather from other sources. (Shh - Don't tell my DR but anytime he says something that I'm not real sure about or aren't sure what he's meaning, I call my PA and ask her - She been my Dr for close to 15 years and I really trust her - if she's not sure about something -she'll find out. She immediately said he's right you don't need the testing.)

Susan

lizzie17

i had both
I had the OncoTypeDX and then about 6 months later they did bloodwork for the genetic component because I have two daughters.

new2me

Rague said:

Didn't have any done.
My Dr saw no need to do genetic testing - For at least 4 generations there has been no known cancer of any kind on either side of my family, with the women usually living into their nineties and a coupld past 100. Also IBC is not usually genetic - but rather from other sources. (Shh - Don't tell my DR but anytime he says something that I'm not real sure about or aren't sure what he's meaning, I call my PA and ask her - She been my Dr for close to 15 years and I really trust her - if she's not sure about something -she'll find out. She immediately said he's right you don't need the testing.)

Susan

My Oncologist wanted me to have it done
but my insurance won't cover it -and it cost over $3,000. I had an aunt on my mothers side that had breast cancer but she was in her last 60's and that was back in early 1980. she died 2 years ago but nothing to do with cancer. I doubt I have the gene !!!

Kelly

Chickadee1955

lizzie17 said:

i had both
I had the OncoTypeDX and then about 6 months later they did bloodwork for the genetic component because I have two daughters.

OncotypeDX and BRCA genetic
OncotypeDX and BRCA genetic testing are two different things. The OncotypeDX is a test that rates your probability of a recurrence with and without chemo to help you decide if you are in the 'gray' area. Some cancers are definite yes--lymph nodes involved, large tumors, etc.; others are less clear cut as respects the benefit of chemo.

BRCA is the expensive test most insurance doesn't cover. It shows if your family has a certain gene that makes it probable you and your daughters, sisters, etc are likely to develop breast cancer or sister cancers.

Chickadee

CypressCynthia

Chickadee1955 said:

OncotypeDX and BRCA genetic
OncotypeDX and BRCA genetic testing are two different things. The OncotypeDX is a test that rates your probability of a recurrence with and without chemo to help you decide if you are in the 'gray' area. Some cancers are definite yes--lymph nodes involved, large tumors, etc.; others are less clear cut as respects the benefit of chemo.

BRCA is the expensive test most insurance doesn't cover. It shows if your family has a certain gene that makes it probable you and your daughters, sisters, etc are likely to develop breast cancer or sister cancers.

Chickadee

Yes, 2 different tests
Oncotype Dx and BRCA testing are different tests used for different reasons.

Oncotype Dx:

"Oncotype Dx is a test that helps predict the chance of distant recurrence (when cancer spreads to other organs) for breast cancers that are:
•Lymph node negative
•Estrogen receptor-positive
Oncotype Dx tests a sample of the tumor (removed during a biopsy or surgery) for a group of 21 genes. Along with other prognostic and diagnostic factors, the results of the Oncotype Dx test can be used to tailor treatment plans. If the test shows a person has a fairly high risk of recurrence, a more aggressive treatment plan that includes hormone therapy and chemotherapy may be advised [30-31]. If the test shows a low risk of recurrence, the use of hormone therapy alone may be considered.

Oncotype Dx is under active study for use in lymph node-positive, estrogen receptor-positive breast cancers [31-33]. Researchers are also studying whether it can predict how well other types of breast cancer will respond to different types of chemotherapy."
http://ww5.komen.org/BreastCancer/OncotypeDX.html

BRCA 1 and 2 Testing:
This test is done with a blood sample (not a tissue sample). It is a test to see if you have a genetic cause (a BRCA mutation) to your breast cancer. A positive result means that you and your relatives may be at risk for breast and other cancers. Relatives may be able to prevent cancer will preventive treatments.

However, a negative result does not mean that you do not have a genetic cause for your cancer; it just means that you do not have the BRCA1 or BRCA2 mutation. Other mutations are being identified, but there is no other test available yet.
http://ww5.komen.org/Content.aspx?id=5332&terms=brca

JuJuBeez

I had both the Oncotype
I had both the Oncotype testing and the BRCA testing. My surgeon requested the BRCA because of my age at dx (43). My onco requested the Oncotype. The BRCA showed no gene mutations. My oncotype score was 12. I had IDC, 1cm tumor, clean lymph nodes, estrogen and progesterone 'strongly' positive. My onco said with a recurrance score of 12, he didn't think chemo was necessary. I had partial-breast radiation 2x/day for 5 days. I was part of a trial-study on the effectiveness of partial-breast radiation vs. whole breast radiation for 6 weeks. My onco is head of research where I go, so he's all about the newest and latest-and-greatest options for us.

I was relieved to know my score. I felt like it helped with the 'chemo, or not to chemo' issue. While nobody 'wants' chemo, if my score had been higher, I certainly would've considered it to help my prognosis. I'm lucky that I have great health insurance that will pay for all this testing. I had the insurance for one month before I was diagnosed. I had gone without health insurance for two years prior. Scary.

joannstar

Neither
Because I was Stage 1 IDC Med Grade 0/4 Triple Negative, I had chemo & rads -- agressive treatment due to the Triple Negative, so I didn't have the Oncotype test.
I don't have children so the Gene test was not suggested either and the only BC was my Great Aunt and she was over 60 when diagnosed.
JoAnn

camul

I had both tests. First one
I had both tests. First one showed the chance for recurrence as low, and genetic tests were negative for Braca I & II. However, I changed onco's and the new one, who was my mothers (for other cancer, and is my sons onco), said he disagreed with no chemo because we were relatively positive that my cancer was a direct result of HRT therapy.

I didn't like the first Dr. at all because of her demeanor with me. So I changed, and love and trust my onco! That was in 2002!

~Carol

tigger99

camul said:

I had both tests. First one
I had both tests. First one showed the chance for recurrence as low, and genetic tests were negative for Braca I & II. However, I changed onco's and the new one, who was my mothers (for other cancer, and is my sons onco), said he disagreed with no chemo because we were relatively positive that my cancer was a direct result of HRT therapy.

I didn't like the first Dr. at all because of her demeanor with me. So I changed, and love and trust my onco! That was in 2002!

~Carol

Wow, that's quite a comment
Wow, that's quite a comment from your doctor!

I had the OncotypeDX test done and my oncologist said it definitely saved me from having chemo. Normally, without the Oncotype test, I definitely would have gotten chemo under the usual protocols, but my score showed that chemo would have no benefit.

My friend, on the other hand, was told her life was probably saved by the Oncotype test. She normally would NEVER have gotten chemo under the usual protocols but her Oncotype score was the highest her oncologist had ever seen. He told her that the Oncotype test very likely saved her life!

cindycflynn

I had the Oncotype DX
My tumor was 1.3 cm, clean lymph nodes, ER+ &PR+, so I fit the profile of someone who would benefit from that test. My test came back in the intermediate range, and I ended up opting to have chemo to be on the safe side.

Since I have no family history of BC, nobody discussed the BRCA test with me, and I don't think there's any reason to do it (especially since I don't have any children).

I am appalled, however, at the arrogant attitude your doctor displayed. Do you have an option to switch doctors? There have been several ladies I've heard from on these boards that switched due to the personality of their doctor, and were very happy that they did.

Best wishes,
Cindy